How to Tailor Your Fitness Routine If You’re Overweight Or Suffer from Metabolic Syndrome

Do you want to exercise to lose weight? Or to control diabetes? Then you should know there's a difficult way... And an efficient way. And they're complete opposites.

The difficult and inefficient way? That's trying to follow the failed advice of just moving around more while eating less. That rarely works in practice. Following that advice makes you hungry and tired, and demands unyielding willpower every day for the rest of your life. It's the hard way.

The smart and efficient way? Let our expert guide you through the maze of exercise tips and routines.

Jonas Bergqvist is a licensed physical therapist who's worked with dietary, exercise and lifestyle coaching for many years. He currently runs a combined health and education centre with courses in, among other things, LCHF and paleo dietary advice. He's also a popular diet guru and has written several diet and exercise books, including (in Swedish) "LCHF and Exercise".

Now it's time for his best advice on the topic of exercise for weight loss and improved health:

This second exercise-themed post is going to deal with the issue of how best to exercise if you're overweight or are suffering from metabolic syndrome.

It should be stated immediately that any kind of exercise is better than no exercise. Also, the more the better, if you keep it at an amateur level. So the first step is all about establishing regular exercise sessions. It's the accumulated volume of exercise over time that brings health benefits, not the effect of single workouts. However, that's not to say that the individual workouts can be any old way you feel like. You can choose to exercise more or less effectively, and that's what this post is all about.

Just to make my terminology clear: when using the term "diabetes" in this text, I'm referring to type 2 diabetes.

There are four pieces of the lifestyle puzzle that have powerful potential to decrease our blood sugar and insulin. As you may know, the latter two are precisely what's elevated in diabetics or people with other metabolic disorders. The four puzzle pieces are:

A low carb diet

Fasting

Exercise

Healthy stress levels and enough sleep.

These big four are shown in the picture below. The strongest effect can be achieved from eating a low carb diet or fasting, which is why you may want to straighten out those parts before turning to exercise. Nevertheless, this post is focused on exercise and how it can be adapted to suit those who are overweight or have diabetes.

The core in chronically elevated blood sugar and insulin - and hence diabetes - is insulin resistance. This means an inability in the body to properly use the hormone insulin. This is why I'm going to specifically address how exercise affects insulin resistance. Even dysfunctional mitochondria and lower mitochondrial density is associated with diabetes. I'll be looking into that, too.

I'll be referring to several scientific studies throughout this post which I use to support my ideas, but you can also use them as guides if you want to delve into the subject for yourselves.

When discussing the benefits of exercise, a distinction can sometimes be made between health and performance benefits. On a professional athletic level, there is a point in discussing the balance between them. But on an amateur level, health and performance often go hand in hand. When you exercise regularly and perform better, your health improves. For example, it has been shown that insulin sensitivity is higher in fitter individuals (1).

Exercise for weight loss

The combination of a low carb diet with strength training is just the diet/exercise combo that gives the biggest decrease in fat mass in both women (2) and men (3). Even if you were confused enough to go for a low-fat diet, your fat mass loss would increase if you were to do cardio workouts, and then even more so if you were to do strength workouts to boot(4). Brought together, these studies show the value of eating a low carb diet and doing strength training to lose fat mass and weight. Remember though - overweight is only indirectly unhealthy: it's a indicator of unhealthy processes going on in your body, the kind that could increase your risk of diabetes and heart disease.

Exercise to reduce insulin resistance

Traditionally, endurance (cardio) workouts have been associated with better heart health while strength (resistance) training has been associated with stronger muscles and bones. A more modern perspective on these two exercise forms is that they have many similarities, and that combining them is extra valuable (confirmed by the above study). The fact is, an American study from 2012 showed that strength training also gave a good effect on insulin sensitivity, that strength training decreased the risk of developing diabetes, but above all, that a combination of strength and cardio exercise lowered that risk even further (5). It's not too radical to assume that the same thing applies to people who already have developed diabetes or other form of metabolic disorder. So strength training appears to bring health benefits, although it is perhaps not as potent as cardio. Strength training may however pack the more powerful punch in view of the hormonal responses it triggers. Being strong will also give you a better foundation for your regular cardio workouts, will decrease the risk of injury, increase performance and through this also health.

Strength training will increase the anabolic hormones in your body. These help to burn fat, to maintain or gain muscle, and this leads to a higher carbohydrate tolerance and therefore higher insulin sensitivity.

Exercise for more and better mitochondria

The amount of mitochondria and their function is related to both heart disease (6), insulin resistance and type 2 diabetes (7). It seems that the mitochondria produce an excess of free radicals in diabetics (8), something which can be a cause or an effect of insulin resistance, because an excess of free radicals impairs the insulin receptor.

Doing cardio when the glycogen levels in your body are low gives more functional mitochondria, as well as a higher count of mitochondria (9). In principle, there are two ways to deplete your glycogen levels - either you can do a glycogen-burning workout, rest for a few hours and work out again, or you can skip a meal or two, and fast. The first alternative might be an option if you're a high-level athlete who's comfortable with two workouts a day, but is probably not an option for those of you who work regular jobs. The latter option is therefore more appropriate for amateurs.

Summary

To sum up exercise for weight loss, insulin sensitivity and mitochondria count and function, the game plan doesn't look much different from the recommendations I would give the healthy population in general. There are, however, some details to keep in mind if you are overweight or have any metabolic disorder:

Forget the conventional exercise advice built on the eat less/run more philosophy. A proper diet is the foundation of weight loss. Exercise will give you a bonus effect. Cardio workouts for the overweight or metabolically disordered should preferably be high-intensity. High intensity interval training has been shown to give similar effects to constant heart rate-type endurance training (10). However, interval training has been reported as less tiring than sustained regular cardio by both healthy women and women with diabetes (11). High intensity interval training is therefore acknowledged as a form of endurance training which is more tolerable and time-efficient (where the latter is sure to appeal to our stress-riddled society). A possible drawback is that the risk of injury is extra high if you're inexperienced. Make sure to choose the type of cardio workout that suits you.

You should also remember to lift heavy. The hormonal effects of strength training become all the more crucial if your goal is to lose weight and regain metabolic balance. Of course, the neuromuscular benefits of better posture, body control and muscular function that you would have gotten from functional training will be foregone, but if you prioritise weight loss and metabolic balance you should channel your efforts accordingly. Skip the difficult, functional exercises. Choose easier exercises that allow you to go heavy without a long learning curve.

You may also want to consider fasting, or rather, exercising on an empty stomach. This will give a big metabolic effect when you're aiming for weight loss and metabolic balance.

1 strength session, 1 pure cardio session, and one combined session a week is a good way to start.

Pick 5 strength exercises that let you ramp up the weights without risking injury.

For your combined workout, you can reduce the number of sets in your strength routine so that it takes 20-25 minutes. Then you can go for an interval workout consisting of 20 seconds of high intensity activity immediately followed by one minute's rest. Doing this 10 times gives an interval workout time of 13 minutes. Start on a bike or a rowing machine if you're overweight, and switch to carrying your body weight running when you get close to your target weight. Or why not try kettlebell swings or burpees?

Fast for 14-16 hours before one or more of these workouts for the best possible results.

The third part is going to be about how you can overcome the two-month slump in exercise motivation.

The MF Group where Jonas works has many things to offer: educational courses, rehab, personal trainer services, health and exercise-related books and fitness tests. However, their website is currently available only in Swedish. If you're interested in just taking a look, here's their site translated by Google: